Q1. A landslide occurred in the middle of the night on 20th July 2023 in a remote mountain hamlet, approximately 60 kilometres from Uttarkashi. The landslide was caused by torrential rains and has resulted in large-scale destruction of property and life. You, as District Magistrate of that area, have rushed to the spot with a team of doctors, NGOs, media and police along with numerous support staff to oversee the rescue operations. A man came running to you with a request for urgent medical help for his pregnant wife who is in labour and is losing blood. You directed your medical team to examine his wife. They return and convey to you that this Woman needs blood transfusion immediately. Upon enquiry, you come to know that a few blood collection bags and blood group test kits are available in the ambulance accompanying your team. Few people of your team have already volunteered to donate blood. Being a physician who has graduated from AIIMS, you know that blood for transfusion needs to be procured only through a recognized blood bank. Your team members are divided on this issue; some favour transfusion, while some others oppose it. The doctors in the team are ready to facilitate the delivery provided they are not penalized for transfusion. Now you are in a dilemma. Your professional training emphasizes prioritising service to humanity and saving lives of individuals.
(a) What are the ethical issues involved in this çase?
(b) Evaluate the options available to you, being District Magistrate of the area.(20)
Model Solutions
Model Structure
Introduction
- Contextual: Around 20 people died and 100 injured - Irshalgad wadi in Khalapur, Raigad district, due to a landslide which occurred late on Wednesday night, close to the Irshalgad fort. (20th July 2023 event) Read
- Summarise the case study or write the dilemma of professional medical, legal code vs moral duty of saving human life
Main Body
You can write stakeholder
(a) Ethical issues involved in this çase
- Compromise of either medical code or compassion towards human
- Disagreement in team makes the situation complex and puts leader into a dilemma situation
- Conflict between objectivity and empathy
- Dilemma situation as a DM(service to humanity and saving lives of individuals) vs Physician (Adhering to medical code)
- Breach of legal and regulatory compliance in an urgent situation
(b) Options available
Option 1: Allow transfusion considering it an exceptional situation
Pros | Cons |
Saving a human life | Compromise of medical and legal code |
Values of compassion and empathy upheld | Breach of objectivity and compliance procedure |
Avoids crisis of conscience | Compromising professional values |
Upheld teachings of training “service to humanity and saving lives of individuals” |
Option 2: Refer patient to the nearby hospital in an ambulance
Pros | Cons |
Following medical and legal code | Delay can cause risk life of the critical patient |
Better facilities in hospital for patient and a newborn | Not best utilisation of available resources present at the site (donors, doctors) |
Adherence to objectivity and compliance | Poor decision making capability in an exceptional & urgent situation |
Option 3: Start the transfusion urgently by taking consent of patient and family members. And arrange other alternatives like arranging blood from a nearby blood bank.
Pros | Cons |
Upholding Professional ethics and values of compassion & empathy | Might cause a delay and increased risk to life |
Fulfilling moral duty of saving human life | Probability of disruption of rescue procedure |
Quick and balanced decision making abilities |
- Exploring alternatives like consulting to legal authorities to discuss exceptions in such a situation
- Volunteers to be aware and reveal their health conditions to avoid any infection
- Professional judgements being a physician
- Post transfusion action of testing all the blood samples and early diagnosis of risk if any
- Document the situation and allow this as an exception instead of regulation
- If the situation is life-threatening, the physician's ethical duty to act in accordance with the principle of beneficence shall prevail
(Not asked to choose most suitable option but you can write best possible option)
Conclusion.
- Civil servants should have emotional intelligence and quick decision making capabilities to address such emergency situations.
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